Update To Access Standards Drive Time Calculations, 42724-42726 [2020-14341]
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Federal Register / Vol. 85, No. 136 / Wednesday, July 15, 2020 / Rules and Regulations
(b) Sections 101(d)(3) and 113, chapter 47,1
and chapter 80 of title 10, United States
Code.
(c) DoD Instruction 6495.02, ‘‘Sexual
Assault Prevention and Response (SAPR)
Program Procedures,’’ May 24, 2017, as
amended (available at https://
www.esd.whs.mil/Portals/54/Documents/DD/
issuances/dodi/649502p.pdf).
(d) 32 CFR part 158, ‘‘Operational Contract
Support.’’
(e) DoD Manual 6400.01, Volume 2,
‘‘Family Advocacy Program (FAP): Child
Abuse and Domestic Abuse Incident
Reporting System,’’ August 11, 2016
(available at https://www.esd.whs.mil/
Portals/54/Documents/DD/issuances/dodm/
640001m_vol2.pdf).
(f) Public Law 114–92, ‘‘National Defense
Authorization Act for Fiscal Year 2016,’’
November 25, 2015.
(g) DoD Directive 7050.06, ‘‘Military
Whistleblower Protection,’’ April 17, 2015
(available at https://www.esd.whs.mil/
Portals/54/Documents/DD/issuances/dodd/
705006p.pdf).
(h) U.S. Department of Justice, Office on
Violence Against Women, ‘‘A National
Protocol for Sexual Assault Medical Forensic
Examinations, Adults/Adolescents,’’ current
version (available at https://www.ncjrs.gov/
pdffiles1/ovw/241903.pdf).
(i) 32 CFR part 310, ‘‘DoD Privacy
Program.’’
(j) DoD Manual 6025.18, ‘‘Implementation
of the Health Insurance Portability and
Accountability Act (HIPAA) Privacy Rule in
DOD Health Care Programs,’’ March 13, 2019
(available at https://www.esd.whs.mil/
Portals/54/Documents/DD/issuances/dodm/
602518m.pdf?ver=2019-03-13-123513-717).
(k) Public Law 113–66, ‘‘The National
Defense Authorization Act for Fiscal Year
2014,’’ December 2013.
(l) Title 5, United States Code.
(m) Public Law 104–191, ‘‘Health
Insurance Portability and Accountability Act
of 1996,’’ August 21, 1996.
(n) DoD Instruction 5505.18, ‘‘Investigation
of Adult Sexual Assault in the Department of
Defense,’’ March 22, 2017, as amended
(available at https://www.esd.whs.mil/
Portals/54/Documents/DD/issuances/dodi/
550518p.pdf?ver=2018-02-13-125046-630).
(o) Sections 584, 585, and 586 of Public
Law 112–81, ‘‘National Defense
Authorization Act for Fiscal Year 2012,’’
December 31, 2011.
(p) Public Law 113–291, ‘‘Carl Levin and
Howard P. ‘Buck’ McKeon National Defense
Authorization Act for Fiscal Year 2015,’’
December 29, 2014.
(q) DoD Manual 8910.01, Volume 1, ‘‘DoD
Information Collections Manual: Procedures
for DoD Internal Information Collections,’’
June 30, 2014, as amended (available at
https://www.esd.whs.mil/Portals/54/
Documents/DD/issuances/dodm/891001m_
vol1.pdf).
(r) Public Law 110–417, ‘‘The Duncan
Hunter National Defense Authorization Act
for Fiscal Year 2009,’’ October 14, 2008.
1 Chapter 47 is also known and referred to in this
part as ‘‘The Uniform Code of Military Justice
(UCMJ).’’
VerDate Sep<11>2014
15:52 Jul 14, 2020
Jkt 250001
(s) DoD Instruction 5545.02, ‘‘DoD Policy
for Congressional Authorization and
Appropriations Reporting Requirements,’’
December 19, 2008 (available at https://
www.esd.whs.mil/Portals/54/Documents/DD/
issuances/dodi/554502p.pdf).
(t) DoD Directive 5124.02, ‘‘Under
Secretary of Defense for Personnel and
Readiness (USD(P&R)),’’ June 23, 2008
(available at https://www.esd.whs.mil/
Portals/54/Documents/DD/issuances/dodd/
512402p.pdf).
(u) Public Law 112–81, ‘‘National Defense
Authorization Act for Fiscal Year 2012,’’
December 31, 2011.
(v) Department of Defense 2014–2016
Sexual Assault Prevention Strategy,’’ April
30, 2014, https://www.sapr.mil/index.php/
prevention.
(w) DoD Instruction 6495.03, ‘‘Defense
Sexual Assault Advocate Certification
Program (D–SAACP),’’ September 10, 2015
(available at https://www.esd.whs.mil/
Portals/54/Documents/DD/issuances/dodi/
649503p.pdf).
(x) Section 577 of Public Law 108–375,
‘‘Ronald Reagan National Defense
Authorization Act for Fiscal Year 2005,’’
October 28, 2004.
(y) U.S. Department of Defense, ‘‘Manual
for Courts-Martial, United States,’’ current
edition (available at https://jsc.defense.gov/
Portals/99/Documents/
MCM2016.pdf?ver=2016-12-08-181411-957).
(z) Title 10, United States Code.
(aa) DoD Instruction 1030.2, ‘‘Victim and
Witness Assistance Procedures,’’ June 4, 2004
(available at https://www.esd.whs.mil/
Portals/54/Documents/DD/issuances/dodi/
103002p.pdf).
(bb) DoD Instruction 5505.19,
‘‘Establishment of Special Victim
Investigation and Prosecution (SVIP)
Capability within the Military Criminal
Investigative Organizations (MCIOs),’’
February 3, 2015, as amended (available at
https://www.esd.whs.mil/Portals/54/
Documents/DD/issuances/dodi/
550519p.pdf).
(cc) Directive-type Memorandum 14–003,
‘‘DoD Implementation of Special Victim
Capability (SVC) Prosecution and Legal
Support,’’ February 12, 2014, as amended
(available at https://www.esd.whs.mil/
Portals/54/Documents/DD/issuances/dtm/
DTM14003_2014.pdf).
(dd) Title 32, United States Code.
(ee) Sections 561, 562, and 563 of Public
Law 110–417, ‘‘Duncan Hunter National
Defense Authorization Act for Fiscal Year
2009,’’ October 14, 2008.
(ff) U.S. Department of Justice, Office on
Violence Against Women, ‘‘National Training
Standards for Sexual Assault Medical
Forensic Examiners,’’ current version
(available at https://www.ncjrs.gov/pdffiles/
ovw/241903).
(gg) DoD Instruction 6025.13, ‘‘Medical
Quality Assurance (MQA) and Clinical
Quality Management in the Military Health
System (MHS),’’ February 17, 2011, as
amended (available at https://
www.esd.whs.mil/Portals/54/Documents/DD/
issuances/dodi/602513p.pdf).
(hh) Office of the Chairman of the Joint
Chiefs of Staff, ‘‘DoD Dictionary of Military
PO 00000
Frm 00038
Fmt 4700
Sfmt 4700
and Associated Terms,’’ current edition
(available at https://www.jcs.mil/Portals/36/
Documents/Doctrine/pubs/dictionary.pdf).
(ii) DoD 4165.66–M, ‘‘Base Redevelopment
and Realignment Manual,’’ March 1, 2006
(available at https://www.esd.whs.mil/
Portals/54/Documents/DD/issuances/dodm/
416566m.pdf).
(jj) Public Law 111–84, National Defense
Authorization Act for Fiscal Year 2010.
(kk) 10 U.S.C. Chapter 47, Uniform Code of
Military Justice.
Dated: June 18, 2020.
Aaron T. Siegel,
Alternate OSD Federal Register Liaison
Officer, Department of Defense.
[FR Doc. 2020–13513 Filed 7–14–20; 8:45 am]
BILLING CODE 5001–06–P
DEPARTMENT OF VETERANS
AFFAIRS
38 CFR Part 17
Update To Access Standards Drive
Time Calculations
Department of Veterans Affairs.
Guidance.
AGENCY:
ACTION:
This Department of Veterans
Affairs (VA) document provides
additional information regarding VA’s
calculation of average drive times for
purposes of eligibility determinations
for covered veterans to access
community care through the Veterans
Community Care Program.
DATES: Effective August 14, 2020.
FOR FURTHER INFORMATION CONTACT:
Joseph Duran, Office of Community
Care (10D), Veterans Health
Administration (VHA), Department of
Veterans Affairs, Ptarmigan at Cherry
Creek, Denver, CO 80209;
Joseph.Duran2@va.gov; 303–370–1637
(this is not a toll-free number).
SUPPLEMENTARY INFORMATION: On June 5,
2019, VA published a final rule at 84 FR
26278 to promulgate 38 CFR 17.4000–
17.4040 to implement the Veterans
Community Care Program established
by section 101 of the John S. McCain III,
Daniel K. Akaka, and Samuel R. Johnson
VA Maintaining Internal Systems and
Strengthening Integrated Outside
Networks Act of 2018 (MISSION Act),
Public Law 115–182.
Section 17.4040 established access
standards for purposes of making
eligibility determinations under the
Veterans Community Care Program
under § 17.4010(a)(4). For primary care,
mental health care, and noninstitutional extended care services,
eligibility is established if VA cannot
schedule an appointment for the
covered veteran with a VA health care
SUMMARY:
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khammond on DSKJM1Z7X2PROD with RULES
Federal Register / Vol. 85, No. 136 / Wednesday, July 15, 2020 / Rules and Regulations
provider for the required care or service:
(i) Within 30 minutes average driving
time of the veteran’s residence; and (ii)
Within 20 days of the date of request
unless a later date has been agreed to by
the veteran in consultation with the VA
health care provider. For specialty care,
eligibility is established if VA cannot
schedule an appointment for the
covered veteran with a VA health care
provider for the required care or service:
(i) Within 60 minutes average driving
time of the veteran’s residence; and (ii)
Within 28 days of the date of request
unless a later date has been agreed to by
the veteran in consultation with the VA
health care provider. VA noted in
§ 17.4040(b) that to calculate average
driving time from the veteran’s
residence in paragraph (a) of the section,
VA would use geographic information
system software.
In the preamble to the final rule, VA
explained that it was not detailing in
regulation a specific methodology for
calculating average drive time because it
was more veteran-centric to maintain
operational flexibility to refine and
improve VA’s average drive-time
calculations in response to experience,
feedback and changing real-world
conditions. See 84 FR 26278, 26299.
This final rule further stated that as VA
gained more experience with
administering the Veterans Community
Care Program and received feedback
from veterans regarding their experience
with the program, VA anticipated
refining the tool to calculate average
drive times as well as VA systems to
improve our consideration of actual
conditions that affect travel to receive
care and services and to provide more
information to veterans regarding
calculation of average drive times. See
84 FR 26278, 26301. This notice serves
to inform the public that VA is will
change the geographic information
system software used to the calculate
average drive times under § 17.4040.
Description of Changes in Calculating
Average Drive Times: As described in
the final rule establishing the Veterans
Community Care Program (84 FR
26278), VA uses a variety of factors,
including distance, route options, and
speed limits to calculate the average
drive time between the veteran’s
residence (as noted in VA’s enrollment
system) and VA facilities that offer the
type of care needed by the Veteran. The
calculation is similar to the calculations
used in popular commercial mapping
software used for point-to-point driving
directions and estimated travel times.
The calculated average is used to
determine whether the veteran is
eligible for community care based on
drive time. The final rule also stated
VerDate Sep<11>2014
15:52 Jul 14, 2020
Jkt 250001
that, in response to comments that
requested clarification on how VA will
calculate average drive times, that some
detailed information regarding average
drive time calculations and algorithms
is proprietary, and VA was unable to
disclose the full method used to make
the calculations. See 84 FR 26278,
26300.
VA recognized the concerns voiced by
veterans and members of the public at
the time we launched the Veterans
Community Care Program regarding
how we calculate average drive time
and whether we are making the best
estimates of average drive times. This
notice about planned refinements is the
result of VA’s efforts to continue
improving how we calculate this
important component of eligibility.
VA is refining the average drive-time
calculations in the online Decision
Support Tool (DST) to improve
eligibility determination results and
response times based on feedback
received from veterans and VA staff
regarding their experiences with the
Veterans Community Care Program
since its implementation on June 6,
2019.
Effective August 14, 2020, VA will
use a new geographic information
system within DST. Under the new
system, VA will determine drive times
between two addresses by developing
‘‘service areas’’ around all VA facilities,
which are bands surrounding the
facility that reflect drive times in ranges
of 10-minute increments, starting with
0–10 minutes, going up to 81–90
minutes. The applicable drive-time
standards depend on the type of care
being requested (i.e., the veteran can get
needed care within 30 minutes’ average
drive time for primary care, mental
health care and extended care services
under § 17.4040(a)(1)(i) or within 60
minutes for specialty care services
under § 17.4040(a)(2)(i)). Users of the
system will get an estimate of the drive
time between the veteran’s residence
and the VA facility in a 10-minute range
under the bands, instead of a single-time
estimate as in the current system.
Covered veterans whose residence
address is within a drive-time service
area range that exceeds the drive-time
standards for the type of care being
sought would be determined to be
eligible under § 17.4010(a)(4).
The new system will use historical
traffic patterns in all searches. The
system will calculate average drive
times based on historical traffic patterns
on Wednesdays at 10 a.m. at the
veteran’s local time for all searches. We
have selected this time and day of the
week to reasonably approximate times
that veterans would be traveling for
PO 00000
Frm 00039
Fmt 4700
Sfmt 4700
42725
appointments, while working within the
capabilities of the system and the
available data. Historical traffic data
will be updated two to three times per
year to reflect changes in local travel
patterns.
Veterans will benefit from this change
in two ways. First, VA believes the new
system will better reflect the actual
conditions that affect the time it takes
for veterans to travel to receive care and
services because of the way that
historical traffic data will be used and
how average travel times will be
calculated. Second, we can now offer
more information to veterans and the
public regarding how VA will calculate
average drive times under this new
system. While VA is primarily making
this change to improve eligibility
determination results and response
times, it will also impact eligibility
under the access standards for some
veterans. VA believes the result will be
an overall increase in eligibility.
We note that the average drive time is
only one element of covered veterans’
eligibility for community care. Since VA
established the Veterans Community
Care Program on June 6, 2019, covered
veterans have also been eligible for
community care under other criteria
(see 38 CFR 17.4010, Veteran
Eligibility). For example, covered
veterans who would not be considered
eligible for community care based solely
on the average drive time element of the
designated access standard criterion
may still be eligible for community care
if the veteran and his or her VA
provider agree that it is in the best
medical interest of the veteran to receive
community care. We remain committed
to ensuring that covered veterans are
referred to community care where it is
in their best medical interest, and
veterans with concerns about whether
they should be referred to the
community are always welcome to
discuss their options with their VA
providers.
Although we are changing the method
of calculating average drive times in our
DST tool, which may affect some
individuals’ eligibility, this notice is not
changing VA’s designated drive time
access standard under § 17.4040. The
average drive times that establish
eligibility under the designated access
standards criterion will remain the same
after VA updates the average drive-time
calculation tool.
VA continues to believe it is more
veteran-centric to maintain the
operational flexibility to refine and
improve VA’s calculations in response
to experience, feedback and changing
real-world conditions, rather than to
detail in regulation a specific
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15JYR1
42726
Federal Register / Vol. 85, No. 136 / Wednesday, July 15, 2020 / Rules and Regulations
methodology or considerations that
could constrain VA’s ability to improve
the calculation of average drive times in
the future. For that reason, we will
continue to update the public through
documents in the Federal Register
about any changes to how we calculate
average drive times for the Veterans
Community Care Program.
Signing Authority
The Secretary of Veterans Affairs, or
designee, approved this document and
authorized the undersigned to sign and
submit the document to the Office of the
Federal Register for publication
electronically as an official document of
the Department of Veterans Affairs.
Brooks D. Tucker, Acting Chief of Staff,
Department of Veterans Affairs,
approved this document on June 23,
2020 for publication.
Jeffrey M. Martin,
Assistant Director, Office of Regulation Policy
& Management, Office of the Secretary,
Department of Veterans Affairs.
[FR Doc. 2020–14341 Filed 7–14–20; 8:45 am]
BILLING CODE 8320–01–P
ENVIRONMENTAL PROTECTION
AGENCY
40 CFR Part 52
[EPA–R09–OAR–2019–0633; FRL–10011–
25–Region 9]
Air Plan Approval; Arizona; Maricopa
County Air Quality Department and
Pima County Department of
Environmental Quality
Environmental Protection
Agency (EPA).
ACTION: Final rule.
AGENCY:
The Environmental Protection
Agency (EPA) is taking final action to
approve revisions to the Maricopa
County Air Quality Department
(MCAQD) and Pima County Department
of Environmental Quality (PCDEQ)
portions of the Arizona State
Implementation Plan (SIP). These
revisions concern emissions of
particulate matter (PM) from
nonmetallic mineral processing,
inactive mineral tailings and slag
storage. We are approving local rules
that regulate these emission sources
under the Clean Air Act (CAA or the
Act).
DATES: These rules will be effective on
August 14, 2020.
ADDRESSES: The EPA has established a
docket for this action under Docket ID
No. EPA–R09–OAR–2019–0633. All
SUMMARY:
documents in the docket are listed on
the https://www.regulations.gov
website. Although listed in the index,
some information is not publicly
available, e.g., Confidential Business
Information (CBI) or other information
whose disclosure is restricted by statute.
Certain other material, such as
copyrighted material, is not placed on
the internet and will be publicly
available only in hard copy form.
Publicly available docket materials are
available through https://
www.regulations.gov, or please contact
the person identified in the FOR FURTHER
INFORMATION CONTACT section for
additional availability information.
FOR FURTHER INFORMATION CONTACT:
Christine Vineyard, EPA Region IX, 75
Hawthorne St., San Francisco, CA
94105. By phone: (415) 947–4125 or by
email at vineyard.christine@epa.gov.
SUPPLEMENTARY INFORMATION:
Throughout this document, ‘‘we,’’ ‘‘us’’
and ‘‘our’’ refer to the EPA.
Table of Contents
I. Proposed Action
II. Public Comments and EPA Responses
III. EPA Action
IV. Incorporation by Reference
V. Statutory and Executive Order Reviews
I. Proposed Action
On May 1, 2020 (85 FR 25379), the
EPA proposed to approve the following
rules into the Arizona SIP.
Adopted/
revised
Local agency
Rule No.
Rule title
MCAQD ..........
PDEQ .............
316 .........................................
Pima County Code Section
17.16.125.
Nonmetallic Mineral Processing .............................................
Inactive Mineral Tailings Impoundment and Slag Storage
Area within the Ajo PM Planning Area.
Submitted
11/07/18
11/19/18
1 01/22/19
2 05/10/19
1 Pima
County Board of Supervisors adopted PCC Section 17.16.125 on January 22, 2019, with an effective date of February 21, 2019.
submitted PCC Section 17.16.125 as part of a larger SIP revision submittal titled ‘‘SIP Revision: Ajo PM10 Redesignation Request and
Maintenance Plan (May 3, 2019)’’ (herein referred to as the ‘‘Ajo PM10 SIP’’). More specifically, appendix C of the Ajo PM10 SIP includes PCC
Section 17.16.125 and the related adoption materials. ADEQ submitted the Ajo PM10 SIP electronically on May 10, 2019, under cover of a transmittal letter dated May 8, 2019. Herein, EPA is taking final action on the PCC Section 17.16.125 portion of the Ajo PM10 SIP. The EPA is taking
action on the rest of the Ajo PM10 Plan in a separate action (85 FR 34381 (June 4, 2020)).
khammond on DSKJM1Z7X2PROD with RULES
2 ADEQ
We proposed to approve these rules
because we determined that they
comply with the relevant CAA
requirements. More specifically, with
respect to MCAQD Rule 316, we
previously determined that the rule
implemented Best Available Control
Measures for nonmetallic mineral
processing within the Phoenix planning
area, and we find that the 2018
amendments to the rule relax no control
requirements and generally clarify and
enhance the effectiveness of the rule.
With respect to Pima County Code
(PCC) Section 17.16.125, we find that
the rule provides a means to ensure the
permanence and enforceability of the
fugitive dust controls that have already
VerDate Sep<11>2014
15:52 Jul 14, 2020
Jkt 250001
been implemented in the Ajo PM10
planning area and that have brought the
area into attainment of the Particulate
Matter equal to or less than 10 microns
in diameter (PM10) National Ambient
Air Quality Standards (NAAQS). Our
proposed action and related technical
support documents (TSDs) contain more
information on the rules and our
evaluation.
III. EPA Action
II. Public Comments and EPA
Responses
IV. Incorporation by Reference
The EPA’s proposed action provided
a 30-day public comment period. During
this period, we received no comments.
In this rule, the EPA is finalizing
regulatory text that includes
incorporation by reference. In
accordance with requirements of 1 CFR
51.5, the EPA is finalizing the
PO 00000
Frm 00040
Fmt 4700
Sfmt 4700
Pursuant to section 110(k)(3) of the
CAA, and for the reasons discussed in
detail in our proposed rule and TSDs,
and summarized above, the EPA is fully
approving MCAQD Rule 316, as
submitted on November 19, 2018, and
PCC Section 17.16.125, as submitted on
May 10, 2019, as revisions to the
Arizona SIP.
E:\FR\FM\15JYR1.SGM
15JYR1
Agencies
[Federal Register Volume 85, Number 136 (Wednesday, July 15, 2020)]
[Rules and Regulations]
[Pages 42724-42726]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-14341]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
38 CFR Part 17
Update To Access Standards Drive Time Calculations
AGENCY: Department of Veterans Affairs.
ACTION: Guidance.
-----------------------------------------------------------------------
SUMMARY: This Department of Veterans Affairs (VA) document provides
additional information regarding VA's calculation of average drive
times for purposes of eligibility determinations for covered veterans
to access community care through the Veterans Community Care Program.
DATES: Effective August 14, 2020.
FOR FURTHER INFORMATION CONTACT: Joseph Duran, Office of Community Care
(10D), Veterans Health Administration (VHA), Department of Veterans
Affairs, Ptarmigan at Cherry Creek, Denver, CO 80209;
[email protected]; 303-370-1637 (this is not a toll-free number).
SUPPLEMENTARY INFORMATION: On June 5, 2019, VA published a final rule
at 84 FR 26278 to promulgate 38 CFR 17.4000-17.4040 to implement the
Veterans Community Care Program established by section 101 of the John
S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining
Internal Systems and Strengthening Integrated Outside Networks Act of
2018 (MISSION Act), Public Law 115-182.
Section 17.4040 established access standards for purposes of making
eligibility determinations under the Veterans Community Care Program
under Sec. 17.4010(a)(4). For primary care, mental health care, and
non-institutional extended care services, eligibility is established if
VA cannot schedule an appointment for the covered veteran with a VA
health care
[[Page 42725]]
provider for the required care or service: (i) Within 30 minutes
average driving time of the veteran's residence; and (ii) Within 20
days of the date of request unless a later date has been agreed to by
the veteran in consultation with the VA health care provider. For
specialty care, eligibility is established if VA cannot schedule an
appointment for the covered veteran with a VA health care provider for
the required care or service: (i) Within 60 minutes average driving
time of the veteran's residence; and (ii) Within 28 days of the date of
request unless a later date has been agreed to by the veteran in
consultation with the VA health care provider. VA noted in Sec.
17.4040(b) that to calculate average driving time from the veteran's
residence in paragraph (a) of the section, VA would use geographic
information system software.
In the preamble to the final rule, VA explained that it was not
detailing in regulation a specific methodology for calculating average
drive time because it was more veteran-centric to maintain operational
flexibility to refine and improve VA's average drive-time calculations
in response to experience, feedback and changing real-world conditions.
See 84 FR 26278, 26299. This final rule further stated that as VA
gained more experience with administering the Veterans Community Care
Program and received feedback from veterans regarding their experience
with the program, VA anticipated refining the tool to calculate average
drive times as well as VA systems to improve our consideration of
actual conditions that affect travel to receive care and services and
to provide more information to veterans regarding calculation of
average drive times. See 84 FR 26278, 26301. This notice serves to
inform the public that VA is will change the geographic information
system software used to the calculate average drive times under Sec.
17.4040.
Description of Changes in Calculating Average Drive Times: As
described in the final rule establishing the Veterans Community Care
Program (84 FR 26278), VA uses a variety of factors, including
distance, route options, and speed limits to calculate the average
drive time between the veteran's residence (as noted in VA's enrollment
system) and VA facilities that offer the type of care needed by the
Veteran. The calculation is similar to the calculations used in popular
commercial mapping software used for point-to-point driving directions
and estimated travel times. The calculated average is used to determine
whether the veteran is eligible for community care based on drive time.
The final rule also stated that, in response to comments that requested
clarification on how VA will calculate average drive times, that some
detailed information regarding average drive time calculations and
algorithms is proprietary, and VA was unable to disclose the full
method used to make the calculations. See 84 FR 26278, 26300.
VA recognized the concerns voiced by veterans and members of the
public at the time we launched the Veterans Community Care Program
regarding how we calculate average drive time and whether we are making
the best estimates of average drive times. This notice about planned
refinements is the result of VA's efforts to continue improving how we
calculate this important component of eligibility.
VA is refining the average drive-time calculations in the online
Decision Support Tool (DST) to improve eligibility determination
results and response times based on feedback received from veterans and
VA staff regarding their experiences with the Veterans Community Care
Program since its implementation on June 6, 2019.
Effective August 14, 2020, VA will use a new geographic information
system within DST. Under the new system, VA will determine drive times
between two addresses by developing ``service areas'' around all VA
facilities, which are bands surrounding the facility that reflect drive
times in ranges of 10-minute increments, starting with 0-10 minutes,
going up to 81-90 minutes. The applicable drive-time standards depend
on the type of care being requested (i.e., the veteran can get needed
care within 30 minutes' average drive time for primary care, mental
health care and extended care services under Sec. 17.4040(a)(1)(i) or
within 60 minutes for specialty care services under Sec.
17.4040(a)(2)(i)). Users of the system will get an estimate of the
drive time between the veteran's residence and the VA facility in a 10-
minute range under the bands, instead of a single-time estimate as in
the current system. Covered veterans whose residence address is within
a drive-time service area range that exceeds the drive-time standards
for the type of care being sought would be determined to be eligible
under Sec. 17.4010(a)(4).
The new system will use historical traffic patterns in all
searches. The system will calculate average drive times based on
historical traffic patterns on Wednesdays at 10 a.m. at the veteran's
local time for all searches. We have selected this time and day of the
week to reasonably approximate times that veterans would be traveling
for appointments, while working within the capabilities of the system
and the available data. Historical traffic data will be updated two to
three times per year to reflect changes in local travel patterns.
Veterans will benefit from this change in two ways. First, VA
believes the new system will better reflect the actual conditions that
affect the time it takes for veterans to travel to receive care and
services because of the way that historical traffic data will be used
and how average travel times will be calculated. Second, we can now
offer more information to veterans and the public regarding how VA will
calculate average drive times under this new system. While VA is
primarily making this change to improve eligibility determination
results and response times, it will also impact eligibility under the
access standards for some veterans. VA believes the result will be an
overall increase in eligibility.
We note that the average drive time is only one element of covered
veterans' eligibility for community care. Since VA established the
Veterans Community Care Program on June 6, 2019, covered veterans have
also been eligible for community care under other criteria (see 38 CFR
17.4010, Veteran Eligibility). For example, covered veterans who would
not be considered eligible for community care based solely on the
average drive time element of the designated access standard criterion
may still be eligible for community care if the veteran and his or her
VA provider agree that it is in the best medical interest of the
veteran to receive community care. We remain committed to ensuring that
covered veterans are referred to community care where it is in their
best medical interest, and veterans with concerns about whether they
should be referred to the community are always welcome to discuss their
options with their VA providers.
Although we are changing the method of calculating average drive
times in our DST tool, which may affect some individuals' eligibility,
this notice is not changing VA's designated drive time access standard
under Sec. 17.4040. The average drive times that establish eligibility
under the designated access standards criterion will remain the same
after VA updates the average drive-time calculation tool.
VA continues to believe it is more veteran-centric to maintain the
operational flexibility to refine and improve VA's calculations in
response to experience, feedback and changing real-world conditions,
rather than to detail in regulation a specific
[[Page 42726]]
methodology or considerations that could constrain VA's ability to
improve the calculation of average drive times in the future. For that
reason, we will continue to update the public through documents in the
Federal Register about any changes to how we calculate average drive
times for the Veterans Community Care Program.
Signing Authority
The Secretary of Veterans Affairs, or designee, approved this
document and authorized the undersigned to sign and submit the document
to the Office of the Federal Register for publication electronically as
an official document of the Department of Veterans Affairs. Brooks D.
Tucker, Acting Chief of Staff, Department of Veterans Affairs, approved
this document on June 23, 2020 for publication.
Jeffrey M. Martin,
Assistant Director, Office of Regulation Policy & Management, Office of
the Secretary, Department of Veterans Affairs.
[FR Doc. 2020-14341 Filed 7-14-20; 8:45 am]
BILLING CODE 8320-01-P